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KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Definitions
- Thrombolysis: Minimally invasive method for clearing/dissolving intravascular thrombus
- IV thrombolysis delivers systemic dose of medication designed to promote fibrinolysis
- Most commonly used form of thrombolysis
- Tissue plasminogen activator (tPA) most frequently used thrombolytic drug
- Most commonly used form of thrombolysis
- Direct intravascular thrombolysis requires placement of catheter/device into thrombosed vessel
- May place either intraarterially or intravenously
- Localized treatment of thrombosed target vessel
- May place either intraarterially or intravenously
- IV thrombolysis delivers systemic dose of medication designed to promote fibrinolysis
- Thrombectomy: Removal of acute or chronic thrombus without use of thrombolytic medications
- Catheter-directed thrombolysis (CDT): Infusion of thrombolytic agent via percutaneously placed catheter
- Delivers concentrated dose to thrombosed vessel
- May be intraarterial or IV
- Mechanical thrombectomy (MT): Fragmentation/aspiration/coring of thrombus using intravascular medical device
- Mechanism of action dependent on device: Macerates clot into macro-/microscopic debris, or aspirates whole thrombus via large-bore catheter
- Rapid, single session treatment
- May be appropriate for patients with contraindication to thrombolytics
- Pharmacomechanical thrombolysis (PCDT): Use of combined mechanical device and thrombolytic agent
- Increases thrombus surface area in contact with thrombolytics
- Thrombolysis: Minimally invasive method for clearing/dissolving intravascular thrombus
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Complications
Expected Outcomes
Selected References
- Buckley JR et al: In-hospital mortality and related outcomes for elevated risk acute pulmonary embolism treated with mechanical thrombectomy versus routine care. J Intensive Care Med. 37(7):877-82, 2022
- Ahmed O et al: Meta-analysis of the usefulness of inferior vena cava filters in massive and submassive pulmonary embolism. Am J Cardiol. 128:54-9, 2020
- Pei DT et al: Meta-analysis of catheter directed ultrasound-assisted thrombolysis in pulmonary embolism. Am J Cardiol. 124(9):1470-7, 2019
- Wible BC et al: Safety and efficacy of acute pulmonary embolism treated via large-bore aspiration mechanical thrombectomy using the Inari FlowTriever Device. J Vasc Interv Radiol. 30(9):1370-5, 2019
- Fleck D et al: Catheter-directed thrombolysis of deep vein thrombosis: literature review and practice considerations. Cardiovasc Diagn Ther. 7(Suppl 3):S228-37, 2017
- Watson L et al: Thrombolysis for acute deep vein thrombosis. Cochrane Database Syst Rev. 11:CD002783, 2016
- Comerota AJ: Thrombolysis for deep venous thrombosis. J Vasc Surg. 55(2):607-11, 2012
- Manninen H et al: Catheter-directed thrombolysis of proximal lower extremity deep vein thrombosis: a prospective trial with venographic and clinical follow-up. Eur J Radiol. 81(6):1197-202, 2012
- Karnabatidis D et al: Quality improvement guidelines for percutaneous catheter-directed intra-arterial thrombolysis and mechanical thrombectomy for acute lower-limb ischemia. Cardiovasc Intervent Radiol. 34(6):1123-36, 2011
- Kühn JP et al: Intraarterial recombinant tissue plasminogen activator thrombolysis of acute and semiacute lower limb arterial occlusion: quality assurance, complication management, and 12-month follow-up reinterventions. AJR Am J Roentgenol. 196(5):1189-93, 2011
- Popuri RK et al: The role of thrombolysis in the clinical management of deep vein thrombosis. Arterioscler Thromb Vasc Biol. 31(3):479-84, 2011
- Schrijver AM et al: Dutch randomized trial comparing standard catheter-directed thrombolysis versus ultrasound-accelerated thrombolysis for thromboembolic infrainguinal disease (DUET): design and rationale. Trials. 12:20, 2011
- Wicky ST: Acute deep vein thrombosis and thrombolysis. Tech Vasc Interv Radiol. 12(2):148-53, 2009
- Semba CP et al: Thrombolysis for lower extremity deep venous thrombosis. Tech Vasc Interv Radiol. 7(2):68-78, 2004
- Semba CP et al: Alteplase as an alternative to urokinase. Advisory Panel on Catheter-Directed Thrombolytic Therapy. J Vasc Interv Radiol. 11(3):279-87, 2000
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Definitions
- Thrombolysis: Minimally invasive method for clearing/dissolving intravascular thrombus
- IV thrombolysis delivers systemic dose of medication designed to promote fibrinolysis
- Most commonly used form of thrombolysis
- Tissue plasminogen activator (tPA) most frequently used thrombolytic drug
- Most commonly used form of thrombolysis
- Direct intravascular thrombolysis requires placement of catheter/device into thrombosed vessel
- May place either intraarterially or intravenously
- Localized treatment of thrombosed target vessel
- May place either intraarterially or intravenously
- IV thrombolysis delivers systemic dose of medication designed to promote fibrinolysis
- Thrombectomy: Removal of acute or chronic thrombus without use of thrombolytic medications
- Catheter-directed thrombolysis (CDT): Infusion of thrombolytic agent via percutaneously placed catheter
- Delivers concentrated dose to thrombosed vessel
- May be intraarterial or IV
- Mechanical thrombectomy (MT): Fragmentation/aspiration/coring of thrombus using intravascular medical device
- Mechanism of action dependent on device: Macerates clot into macro-/microscopic debris, or aspirates whole thrombus via large-bore catheter
- Rapid, single session treatment
- May be appropriate for patients with contraindication to thrombolytics
- Pharmacomechanical thrombolysis (PCDT): Use of combined mechanical device and thrombolytic agent
- Increases thrombus surface area in contact with thrombolytics
- Thrombolysis: Minimally invasive method for clearing/dissolving intravascular thrombus
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Complications
Expected Outcomes
Selected References
- Buckley JR et al: In-hospital mortality and related outcomes for elevated risk acute pulmonary embolism treated with mechanical thrombectomy versus routine care. J Intensive Care Med. 37(7):877-82, 2022
- Ahmed O et al: Meta-analysis of the usefulness of inferior vena cava filters in massive and submassive pulmonary embolism. Am J Cardiol. 128:54-9, 2020
- Pei DT et al: Meta-analysis of catheter directed ultrasound-assisted thrombolysis in pulmonary embolism. Am J Cardiol. 124(9):1470-7, 2019
- Wible BC et al: Safety and efficacy of acute pulmonary embolism treated via large-bore aspiration mechanical thrombectomy using the Inari FlowTriever Device. J Vasc Interv Radiol. 30(9):1370-5, 2019
- Fleck D et al: Catheter-directed thrombolysis of deep vein thrombosis: literature review and practice considerations. Cardiovasc Diagn Ther. 7(Suppl 3):S228-37, 2017
- Watson L et al: Thrombolysis for acute deep vein thrombosis. Cochrane Database Syst Rev. 11:CD002783, 2016
- Comerota AJ: Thrombolysis for deep venous thrombosis. J Vasc Surg. 55(2):607-11, 2012
- Manninen H et al: Catheter-directed thrombolysis of proximal lower extremity deep vein thrombosis: a prospective trial with venographic and clinical follow-up. Eur J Radiol. 81(6):1197-202, 2012
- Karnabatidis D et al: Quality improvement guidelines for percutaneous catheter-directed intra-arterial thrombolysis and mechanical thrombectomy for acute lower-limb ischemia. Cardiovasc Intervent Radiol. 34(6):1123-36, 2011
- Kühn JP et al: Intraarterial recombinant tissue plasminogen activator thrombolysis of acute and semiacute lower limb arterial occlusion: quality assurance, complication management, and 12-month follow-up reinterventions. AJR Am J Roentgenol. 196(5):1189-93, 2011
- Popuri RK et al: The role of thrombolysis in the clinical management of deep vein thrombosis. Arterioscler Thromb Vasc Biol. 31(3):479-84, 2011
- Schrijver AM et al: Dutch randomized trial comparing standard catheter-directed thrombolysis versus ultrasound-accelerated thrombolysis for thromboembolic infrainguinal disease (DUET): design and rationale. Trials. 12:20, 2011
- Wicky ST: Acute deep vein thrombosis and thrombolysis. Tech Vasc Interv Radiol. 12(2):148-53, 2009
- Semba CP et al: Thrombolysis for lower extremity deep venous thrombosis. Tech Vasc Interv Radiol. 7(2):68-78, 2004
- Semba CP et al: Alteplase as an alternative to urokinase. Advisory Panel on Catheter-Directed Thrombolytic Therapy. J Vasc Interv Radiol. 11(3):279-87, 2000
